Unsatisfactory cardiovascular risk control - opportunities for family medicine

Abstract

Although theoretically very effective and apparently quite straightforward, cardiovascular prevention leaves much to be desired in practice. Several reasons, including ethical, conceptual, psychological, and Klju~ne besede: sr~no-`ilne bolezni, prepre~evanje, dru`inska medicina Zdrav Var 20; 50: 75-8 doi 0.2478/v052-00-0030-9 Medical research has markedly improved the knowledge of etiology and prevention of cardiovascular conditions, particularly coronary heart disease (CHD), so that these disorders could virtually be eliminated. Indeed, several years ago, the global community was seemingly approaching the eradication of atherosclerosis, the leading cause of cardiovascular morbidity and mortality. Unfortunately, in reality the expectations had not been met: nowadays the decrease in CHD in economically developed countries is stagnant (), the prevalence of CDH is probably increasing (2), while in developing and transitional countries it is escalating (3). This gloom picture is often attributed to unavailability of or to a delay in using modern invasive procedures and new medications, particularly in patients with heart attack or stroke.Although this segment of management should not be neglected (e.g. prompt and accurate diagnosis, early initiation of treatment in family practice, faster transportation, better organization and distribution of adequately staffed and well equipped interventional units), the bulk of the problem lies at the other end of the clinical spectrum -in unsatisfactory prevention. The EURASPIRE III results (4) show that during the past decade the prevalence of obesity among coronary patients in Europe has increased from 25% to 38%, and that of diabetes from 7.4% to 28%, while smoking and hypertension rates remained unchanged, i.e. approx. 20 % and 60%, respectively. Which are the obstacles on the path to effective primary prevention of CHD, i.e. to adequate protection of apparently healthy, younger people against adverse Unauthenticated Download Date | 5/12/18 4:48 AM

Awareness and Use of Evidence-based Medicine Databases and Cochrane Library Among Physicians in Croatia

“…It has already been observed that family physicians in Croatia had positive attitude toward science, but only 6% published an article in a PubMed-indexed journal (22). At 4 medical schools in Croatia, a total of 61 faculty members in the Departments of Family Medicine in 2007 published 316 scientific and professional articles and a half of them had research degrees (25). However, family medicine faculty comprises only 2% of family physicians in Croatia and they are not representative of family medicine practitioners in Croatia.…”

Usability of Wireless ECG Body Sensor for Cardiac Function Monitoring During Field Testing

“…Goodman et al [11] noticed that the key challenge is identification of structural heart disease and inheritable conditions that increase incidence for lethal arrhythmias during exercise, because sudden cardiac events often occur without any warning or prediction. Therefore, early detection of persons with higher risk for sudden cardiac death is of crucial importance [12]. In this regard, numerous European countries have introduced a mandatory medical examination for all persons registered in sports clubs or associations.…”

Are characteristics of team members important for quality management of chronic patients at primary care level?

“…The introduction of a nurse practitioner to a family physician's team offers the opportunity for interprofessional teamwork aimed at a higher quality of patient care. In many European countries, nurse practitioners have already been introduced to primary care teams to improve quality of care and to reduce healthcare costs (Dierick-van Daele, Metsemakers, Derckx, Spreeuwenberg, & Vrijhoef, 2009;Klemenc-Ketis, Terbovc, Gomiscek, & Kersnik, 2015;Petek & Mlakar, 2016;Rumboldt, Kuzmanic, Petric, & Rumboldt, 2011;Svab, Petek-Ster, Kersnik, Zivcec-Kalan, & Car, 2005). It has been shown that nurse practitioners can even achieve similar health outcomes to family physicians themselves (Dierick-van Daele et al, 2009;Laurant et al, 2008;Voogdt-Pruis, Beusmans, Gorgels, Kester, & Van Ree, 2010).…”